From Breastfeeding: Gold Standard for the new Millennium by Marie Davis
CME resources 2000

Possible Effects of Childhood Sexual Abuse on Breastfeeding

We are only beginning to look at the effects of childhood sexual abuse on 
ability and desire to breastfeed. A study done by Louise Acheson, MD, 
published in the Archives of Family Medicine (1995; 4:650-2) notes that 
“women who did not breastfeed their newborns were 38 times more likely to 
have been battered or sexually abused, or have children who were abused, than 
breastfeeding women.” 
Many survivors have distorted body images and low self esteem. They have 
trouble with the feelings they have, especially if the abuse involved the 
breast. 
Women who are sexual abuse survivors should be offered the option of 
exclusive pumping.
One survivor was willing to share her feelings about the need for education:
“I think that if I knew ahead of time the guilt and feelings I'd have about 
doing something that was supposed to be so natural (breastfeeding), I could 
have been prepared. I had seen my psychiatrist a few times near the end of my 
pregnancy. We talked about my anxiety over giving birth, he knew I was 
planning to breastfeed, but emotions surrounding
breastfeeding weren't discussed — I thought I wouldn't have ‘real’ issues 
there, that nature would just take over (after all, that wasn't the end of my 
body that I had problems with).
And it did go well initially. It wasn't until a few weeks after birth that I 
had trouble dealing with breastfeeding. I had a hard time allowing my baby 
free access to something that was once so sexual.
I did have discussions with my doctor about my anxieties, but I never knew 
abuse issues could come up while breastfeeding. I wish I could have known . . 
. maybe then it wouldn't have been so easy to stop breastfeeding when the 
suggestion was brought up. Not once did anyone suggest exclusive pumping. I 
think that's important, because I had no problem pumping. If I knew that 
there was such an alternative, I'd have jumped all over it."
Sexual abuse survivors may have difficulty with childbirth and breastfeeding.
A positive history of sexual abuse is often the reason she does not wish to 
nurse the baby at her breast. If they aren't currently in a recovery program, 
these women should be referred to a recovery counselor as soon as possible. 
If a mother chooses to pump and bottle feed her milk, she should be 
encouraged to do so. Many of my clients have exclusively pumped for a year or 
more.
~~~~~~~~~~~
Just something to think about.

Marie Davis, RN, IBCLC
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